| | |  | |  | IVF Doctors and Infertility Clinics in Kansas City, Kansas. | | |
Reproductive Resource Center
One married couple in six confronts infertility. Although infertility is clinically defined as the inability to conceive a pregnancy after one year of unprotected intercourse, some couples warrant earlier diagnosis and treatment. There are many causes. Fortunately, advances in reproductive research and technology offer many encouraging treatment options for infertile couples who wish to start or enlarge their families.
Since fertility, especially in the female, begins to decrease after the age of 30, successful treatment usually correlates with prompt and timely, effective reproductive health care.
For half of infertile couples, long established medical treatment or surgical procedures successfully treat the problem. Other couples may need more advanced treatment modalities, such as in vitro fertilization / assisted reproductive technology (IVF/ART). Since 1988, Reproductive Resource Center has earned widespread recognition and nationwide respect as a leader in assisted reproductive technologies.
Intrauterine insemination is performed in conjunction with ovulation induction and clomiphene citrate or gonadotropins. These procedures are used in cases of unexplained infertility, in cases of poor mucous, when sperm cannot pass through the cervix to reach the uterus and tubes, or in cases of mild male factor infertility. This procedure involves inseminating the husband's sperm or donor sperm into the woman's uterine cavity at the time of ovulation.
The sperm must be treated appropriately before the insemination so that the chances of conception are improved and the chances of complications minimized. The sperm sample is "washed" which separates the sperm cells from the seminal plasma. The seminal plasma contains prostaglandins that cause uterine cramping. It may also contain other factors which inhibit normal fertilization.
The sperm sample that is provided to the laboratory goes through the following wash procedure:
The sample is labeled with the patient's name and transferred to a test tube of solution that has been warmed to 37°C (normal body temperature). This tube is also identified with the patient's name. The semen is mixed with the culture medium and then centrifuged (a very fast spinning process) so that the sperm form a pellet on the bottom of the tube and the seminal plasma and medium remain on top. The top layers are removed and the sperm is resuspended into medium and again centrifuged.
www.rrc.com
12200 West 106th Street | Suite 120 Overland Park, KS 66215 | Phone: 913.894.2323 | Fax: 913.894.0841
Kansas City Urology
Infertility is a common problem affecting up to 15% of couples. In over 50% of cases a male factor is solely responsible or is contributing to the problem. Many causes of
male infertility exist ranging from hormonal,blockages,genetic,environmental/lifestyle, medications or unexplained to name a few. Certain potentially life-threatening medical conditions may present for the first time as the inability to achieve a pregnancy and lower sperm counts, such as testicular tumors and some brain tumors. They are uncommon, and the reason why male patients should be evaluated in couples that have infertility.
The evaluation should involve a thorough history and physical and evaluate some of the risk factors that are known to cause male infertility e.g. some childhood disorders that do not become a concern until later in life e/g undescended testicle(s); infections; smoking, alcohol and drug use; certain issues with heat (not boxers or briefs – a myth); cancer treatments; spinal cord injury and other medical conditions. Blockages of the reproductive tract can sometimes be the cause and possible reconstruction using microsurgery can be performed to reverse this and avoid assisted reproduction techniques (ART) and have children naturally. Unfortunately these blockages sometimes cannot be corrected and sperm retrieval techniques and sperm freezing are required for in vitro fertilization (IVF) with intracytoplasmic injection (ICSI) – one sperm injected into an egg outside the body.
Correction of men with low counts and/or motility can also be corrected with a full evaluation, correcting any treatable causes e.g. manipulation of hormones, and correction of certain conditions such as varicoceles – dilated veins in the scrotum that are thought to increase scrotal temperature and affect sperm production. Up to 40% of men who present with infertility have a varicocele on exam. Treatment for this requires careful patient selection and can result in 40-70% improvement in sperm production and up to 40% improvement in pregnancy rates. Even some men with no sperm in their semen who have a varicocele may get return of sperm (approx 17%). It is important to know that the number of sperm is usually not enough for natural conception in these cases and would require ART with IVF. Correction of the varicocele is a same day surgery as an outpatient but is in the operating room and requires an operating microscope to tie off the veins accurately and completely without causing damage to the blood supply to the testicle. Embolization of the veins can also be performed.
www.urologyatkumed.com
3901 Rainbow Blvd
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